背景:这项研究旨在评估连续18个月的青光眼患者经巩膜微睫状体光凝(µCPC)的有效性和安全性。
方法:61例原发性和继发性青光眼患者(64只眼)被纳入接受µCPC(二极管激光FOX810,A.R.C.激光,纽伦堡,德国)。主要结果指标是眼内压(IOP)降低,成功率,青光眼药物使用,和µCPC后的视力。与基线值相比没有再干预的IOP降低20%被认为是成功的治疗。完全成功被定义为停止抗青光眼药物。次要结果指标包括术中和术后并发症。术前和第一周进行测量,术后1、3、6、12和18个月。
结果:术前1天眼压的平均值±SD值,1周,术后1、3、6、12和18个月为25.1±8.4mmHg,17.3±4.5mmHg(p<0.001),16.5±6.1mmHg(p<0.001),20.5±8.3mmHg(p<0.001),17.1±6.2mmHg(p<0.001),18.0±7.1mmHg(p<0.001),15.8±3.2mmHg(p<0.001),17.0±5.9mmHg(p<0.001),分别。末次随访时平均眼压降低32.5%。与基线相比,每次随访时,抗青光眼药物数量的减少具有统计学意义。合格率为38.5%。两名患者在18个月的随访中不需要使用抗青光眼药物-完全成功率-3.1%。在后续期间,由于未达到目标IOP而需要再治疗的25只眼睛(39.1%)被认为是失败.11例患者(12只眼-18.8%)失访。在µCPC后18个月对26例患者(27只眼)进行了评估。手术后,在一名患者(1.6%)和两名患者(3.1%)中观察到葡萄膜炎。术中或术后无明显并发症发生。
结论:在中期随访中,µCPC在降低青光眼患者眼压方面具有良好的耐受性和安全性;然而,成功是适度的。随机化,需要更大的研究来证实获得的结果。
BACKGROUND: This
study aimed to assess the effectiveness and safety of transscleral microcyclophotocoagulation (µCPC) in patients with glaucoma for eighteen consecutive months.
METHODS: Sixty-one patients (64 eyes) with primary and secondary glaucoma were enrolled to undergo µCPC (diode laser FOX 810, A.R.C. Laser, Nuremberg, Germany). The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use, and visual acuity after µCPC. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and at the first week, and 1, 3, 6, 12, and 18 months postoperatively.
RESULTS: The mean ± SD values of IOP preoperatively at 1 day, 1 week, 1, 3, 6, 12, and 18 months postoperatively were 25.1 ± 8.4 mmHg, 17.3 ± 4.5 mmHg (p < 0.001), 16.5 ± 6.1 mmHg (p < 0.001), 20.5 ± 8.3 mmHg (p < 0.001), 17.1 ± 6.2 mmHg (p < 0.001), 18.0 ± 7.1 mmHg (p < 0.001), 15.8 ± 3.2 mmHg (p < 0.001), and 17.0 ± 5.9 mmHg (p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 32.5%. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. The qualified success rate was 38.5%. Two patients at 18-month follow-up did not require the use of antiglaucoma medications-complete success rate-3.1%. During the follow-up period, twenty-five eyes (39.1%) that required retreatment due to nonachievement of the target IOP were considered as failures. Eleven patients (12 eyes-18.8%) were lost to follow-up. A total of 26 patients (27 eyes) were evaluated 18 months after µCPC. Hypotony was observed in one patient (1.6%) and uveitis in two patients (3.1%) after the procedure. There were no other significant intraoperative or postoperative complications observed.
CONCLUSIONS: The µCPC is well tolerated and safe for reducing IOP in glaucoma patients in medium-term follow-up; however, success is moderate. Randomized, larger studies are needed to confirm the obtained results.